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Updated: Sep 8, 2025

Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
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Paracetamol preceding very preterm birth: Is it safe?

Aliisa Laitala1, Timo Saarela1, Marja Vääräsmäki2

  • 1PEDEGO Research Unit and MRC Oulu, University of Oulu and Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland.

Acta Obstetricia Et Gynecologica Scandinavica
|June 16, 2022
PubMed
Summary

Paracetamol use before birth did not adversely affect high-risk preterm infants. Exposed infants required fewer delivery room interventions, suggesting potential benefits for perinatal adaptation.

Keywords:
Apgar scoresacetaminophenblood pressurepain therapypremature infantrespiratory support

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Area of Science:

  • Neonatology
  • Perinatal Medicine
  • Pharmacology

Background:

  • Paracetamol is commonly used for pain relief during pregnancy.
  • The safety of antenatal paracetamol for high-risk preterm infants' perinatal adaptation is not well-established.
  • Concerns exist due to the known harm of other prostaglandin synthesis inhibitors in very preterm infants.

Purpose of the Study:

  • To investigate the influence of antenatal paracetamol use on neonatal adaptation in high-risk infants born before 32 weeks of gestation.
  • To assess the safety and outcomes of these infants during their first hospitalization.

Main Methods:

  • A matched cohort study of high-risk mothers and infants (born <32 weeks gestation) over 84 months.
  • Exposition: paracetamol use within 24 hours before childbirth.
  • Controls: no paracetamol use up to 1 week before delivery. Infants with major anomalies were excluded.

Main Results:

  • No adverse perinatal reactions were observed in paracetamol-exposed infants (n=88) compared to controls (n=85).
  • No differences in circulatory support or major diseases during the first hospitalization.
  • Paracetamol-exposed infants required fewer acute delivery room therapies (51.1% vs 65.9%). Maternal paracetamol dose correlated positively with Apgar scores.

Conclusions:

  • Antenatal paracetamol administered within 24 hours before birth appears safe for extremely or very preterm infants.
  • Further large-scale prospective studies are needed to confirm long-term safety and potential acute benefits during perinatal transition.